Background and Objective: Diabetes and tuberculosis are closely related to each other between the two risk factors, often inter-related, when diabetes patients comes with TB (DMTB) the case mix and complete treatment rate will be more serious than only have TB or diabetes.
Methods: This research used secondary material, belonging to longitudinal study.
We used the National Health Insurance database by National Health Research Institutes, Surveys of Family Income and Expenditure (SFIE), Ministry of the Interior of Department of Statistics, Current Situation of Medical Facilities, Medical Personnel, and Medical Services of Taiwan Public Health Report for statistical analysis from 1997 to 2007. That used national health insurance dataset of diabetes which including all nationwide diabetes claim data to analyze the prevalence, incidence, and the relative risk of diabetes patients to general population to suffer from tuberculosis.
Results: The results showed that the prevalence of diabetes was increased from 3.49% in 1997 to 5.43% in 2007. The study found that the prevalence of DM and DMTB increased year by year, the incidence of DM was decreased from 164.94 per ten thousand population in 1998 to 82.12 per ten thousand population in 2007. For DMTB, the highest incidence was 36.03 per ten thousand population in 1998, and it was decreased from 32.21 per ten thousand persons in 1999 to 19.63 per ten thousand persons in 2007.The new diabetics were followed from one year to nine years, and we found that the relative risk of diabetics combined TB
compared to general population was 1.34 to 4.74, the OR of the first year of suffering from TB was highest. After controlling for other variables, the analysis results of logistic regression influence the related factors of DM patients contract TB as follows: male have more possibility than female, the OR of male to have TB is 3.52 times higher than female, and for each first-year diabetics the possibility to have TB is 1.02 times higher than those who only have diabetes. The higher proportion of agricultural population in medical regions has 1.13 times possibility than lower regions. Catastrophic illness Outpatient having TB is 1.36 times than without catastrophic illness Outpatient, and for each additional CCI the possibility to have TB 1.03 times than those who only have diabetes. But for each additional Complications the possibility to have TB reduced 0.77 times than those who only have diabetes. The OR of type 2 to have TB is 1.46 times higher than type 1.
Conclusion: This study found that prevalence of DM increased year by year, but the diabetes and the incidence of diabetes tuberculosis are declining year after year; 1-9 year follow-up found that tuberculosis complicated by diabetes in relation to the risk of the general population (OR), its first year of suffering from tuberculosis is the highest relative risk; the impact of diabetes-related risk factors
of TB for the importance of gender, age, major injuries, severity of illness, such as type of diabetes.
Recommendations: In addition to diabetes control their blood sugar, strengthen the general population for diabetes by self-education, dietary guidance,
developing a campaign to encourage the involvement of customs-related measures, and regular screening to reduce the blood sugar of diabetes
prevalence. For disease screening and prevention, it can be specifically targeted high-risk diabetes screening and health promotion, and to strengthen its
tuberculosis screening, when a lesion may be the early detection of early treatment.
